Scabies

Scabies is a skin condition caused by tiny mites burrowing under the skin, which triggers allergic reactions leading to itching, rashes, and blisters. While the hands and fingers are the most commonly affected areas, scabies can also spread to other parts of the body. The condition is highly contagious, so it's recommended that everyone in an affected household undergo treatment to prevent further spread. Common treatments include topical medications such as pyrethroids and antiparasitics.

Causes

• Scabies is caused by the Sarcoptes scabiei mite, an invisible parasitic organism.

• The infestation starts when female mites bury themselves just beneath the skin surface to lay eggs, creating tiny tunnels.

• After the eggs hatch, the young mites grow and continue spreading the infestation.

• Transmission mainly occurs through prolonged, direct skin contact with an infected person, often in close-knit environments like family homes, nursing homes, and prisons.

• Although less common, scabies can be spread by sharing contaminated clothing, towels, or bedding.

• It's crucial to note that pets do not transmit the human form of scabies to people.

Symptoms

Here are key symptoms that can help identify scabies:

• Intense Itching: Severe itching, particularly at night, often disrupts sleep.

• Rash Appearance: Red or blister-like bumps may appear, resembling pimples.

• Common Affected Areas: These bumps typically occur between the fingers, on wrists, elbows, and knees, around the waist, and in folds such as the armpits, groin, and genital areas.

• Young Children's Affected Areas: In children, scabies can also appear on the head, face, neck, palms, and soles.

• Distinctive Burrows: Look for thin, wavy, raised lines on the skin surface from burrowing mites.

• Delayed Symptoms: Symptoms may take weeks to manifest after infection, yet scabies can be contagious before symptoms are visible.

If you experience these symptoms, it's crucial to seek guidance from a healthcare provider promptly.

Diagnosis

Scabies is typically diagnosed through a physical examination where healthcare professionals look for rashes and burrows that suggest mite infestation. To confirm the presence of mites or their eggs, a skin sample may be taken and examined under a microscope. Alternatively, a magnifying tool called a dermoscope may be used to identify characteristic burrow patterns. Videodermatoscopy is an advanced, less common method that may be used if initial tests are inconclusive. Accurate and timely diagnosis is vital for beginning treatment and preventing transmission.

Treatments

Scabies is primarily treated with prescription medications. Common treatments include topical creams like Permethrin and Sulfur, applied from the neck to the feet, needing to remain on the skin for 8 to 14 hours. For severe or treatment-resistant scabies, such as crusted scabies, an oral medication called Ivermectin may be prescribed. This is generally reserved for situations where topical treatments fail and is not usually recommended for young children, pregnant women, or breastfeeding mothers. Itching may continue for weeks as the skin heals. If symptoms persist or new rashes appear, additional medication or alternative treatments may be needed. Whole-household treatment is necessary to prevent re-infestation, generally effective after a single treatment with major symptom relief experienced over weeks.

Medications

Effective scabies treatment involves medications designed to eradicate both mites and their eggs:

• Permethrin Cream: This is the most commonly prescribed medication. Applied from the neck down, it should remain for 8 to 14 hours. Permethrin is safe for children over 2 months old and pregnant or breastfeeding women.

• Sulfur Cream: Suitable for all age groups, it requires several consecutive night applications and is used when other treatments aren't appropriate.

• Ivermectin: An oral medication for severe cases or when topical creams fail, not recommended for young children or pregnant women.

Itching might persist for several weeks post-treatment despite the successful elimination of mites.

Prevention

To prevent scabies transmission, consider these measures:

• Launder Bedding and Clothing: Wash all garments, towels, and bedding in hot, soapy water, and dry them on high heat to kill mites and eggs.

• Handle Non-washable Items: Seal items like pillows or stuffed toys in plastic bags for a week, ensuring any mites die from lack of human contact.

• Check and Treat Contacts: Simultaneous treatment for all close contacts, such as family and roommates, is crucial to break transmission cycles.

• Avoid Direct Skin Contact: Limit skin-to-skin contact with known scabies cases, especially during outbreaks.

• No Vaccine Available: Note, there is currently no vaccine for scabies; hence preventive actions are paramount.